Outcomes of 1064-nm picosecond laser alone and in combination with fractional 1064-nm picosecond laser in tattoo removal.

BACKGROUND: Removal of the unwanted tattoo was initially focused treatment of picosecond laser in the setting of the unfractionated beam, whereas the fractionated 1064-nm picosecond lasers (Fr-Pico) has been successfully utilized in various skin conditions, including scar and benign pigmented lesions. However, no studies compared the combination of Fr-Pico and unfractional 1064-nm picosecond laser (UFr-Pico) and UFr-Pico alone in tattoo removal. OBJECTIVE: This study aims to compare the efficacy and safety of the combination of Fr-Pico and UFr-Pico and the UFr-Pico and in tattoo removal. MATERIALS AND METHODS: Nineteen black tattoos in 11 patients were treated with UFr-Pico on one half and in combination with Fr-Pico on another half over three sessions with 4-week intervals and 4-week follow-up after the last session. Treatment efficacy was assessed using digital photographs, skin imaging analysis, and patient satisfaction. RESULTS: After three treatments, tattoo clearance scores revealed that greater than 50% clearance was achieved in 11 (84.6%) tattoos treated with combination side and 9 (69.2%) tattoos with UFr-Pico alone. Significant differences were observed between the groups at 8 and 12 weeks. Skin textural changes also demonstrated significant improvements in the combination side at Week 12. Adverse events, such as blistering and textural changes, were fewer in the combination side. CONCLUSION: The combination of 1064 nm Fr-Pico and UFr-Pico may be more effective and safer in tattoo removal than UFr-Pico alone.

Comparison of Fractional Picosecond 1064-nm Laser and Fractional Carbon Dioxide Laser for Treating Atrophic Acne Scars: A Randomized Split-Face Trial.

BACKGROUND: To date, no studies have compared the fractional picosecond 1064-nm laser (FxPico) and fractional carbon dioxide laser (FxCO2) for the treatment of acne scars. OBJECTIVE: To compare the efficacy and safety between FxPico and FxCO2 for treating facial atrophic acne scars. MATERIALS AND METHODS: Twenty-five Asian patients with mild to moderate atrophic acne scars underwent single sessions of randomized split-face treatment with FxPico and FxCO2. Clinical efficacy was assessed by photographs, skin imaging analysis, and patient satisfaction. The adverse events were recorded on every visit. Skin biopsies were performed immediately and 3 months after treatment. RESULTS: The physician improvement scores for skin texture and atrophy significantly increased on the FxPico sides, but no significant difference was observed between FxPico and FxCO2. Skin imaging also showed significant improvement on both sides for scar volume. Postinflammatory hyperpigmentation (PIH) was not reported on FxPico sides, whereas 6 patients (24%) experienced mild PIH on FxCO2 sides. Immediate post-FxPico skin biopsy revealed laser-induced optical breakdown with photoacoustic columns. Collagen and elastic fibers increased at 3 months after both treatments. CONCLUSION: FxPico was as effective as FxCO2 in treating atrophic acne scars, correlating with evidence of tissue remodeling with more safety profiles.

Botulinum toxin type A injection-related suppurative granuloma: a case report.

Botulinum toxin type A (BoNTA) injection has become increasingly popular for esthetic minimally invasive procedures worldwide, owing to its efficacy and safety. Serious and long-term complications are rare. Here, we report a case of painless skin-colored cutaneous nodules on the face that developed a few days after BoNTA injection. The histopathology revealed a suppurative granuloma which yielded negative results for all organisms on histochemical staining and tissue culture. While waiting for the results of polymerase chain reaction (PCR), we started administration of systemic broad-spectrum antibiotics that were effective against atypical mycobacteria, since suppurative granuloma is usually related to mycobacterial infection, and a negative result of histochemical staining is common among these organisms. The nodules were flattened down after antibiotics started 6 weeks . All lesions were clear without any scar after 6 months of treatment.

Split face comparison between common concentration vs double dilution of intradermal abobotulinum toxin type A (Dysport) injection for facial lifting in Asians.

BACKGROUND: The most efficacious concentration of botulinum toxin for facial lifting is not well established. OBJECTIVE: This study compared the efficacy of common concentration vs double dilution of intradermal abobotulinum toxin type A (Dysport) injection for facial lifting in Asians. METHODS: In all, 10 women aged 32-61 years with mild to moderate facial laxity participated in this study. Each patient received one session of intradermal injection of double diluted abobotulinum toxin type A (Dysport) (dilution of 15 mL to give 3.33 units per 0.1 mL) on one side of the face and common concentration (dilution of 7.5 mL to give 6.67 units per 0.1 mL) on the opposite side of the face. Clinical improvement of facial lifting, wrinkling, and subjective satisfaction was evaluated at every visit (baseline, 2, 4, 8, and 12 weeks). RESULTS: Both concentrations offered reduction of facial laxity and wrinkles, with no statistical difference. The effects gradually increased and lasted for a minimum 12 weeks with both concentrations. CONCLUSION: Common concentration and double dilution of intradermal abobotulinum toxin type A (Dysport) injection were effective and safe for facial lifting in Asians. There were no statistically significant differences between the two concentrations.

Fractional ablative and nonablative radiofrequency for skin resurfacing and rejuvenation of Thai patients.

BACKGROUND: Fractional radiofrequency (RF) technology is often the preferable skin resurfacing treatment, especially among Asian patients. Second generation fractional RF technology has exclusive capability to produce separate biological responses (ablation, coagulation, or a combination of both) with 3 distinguished penetration depth programs. AIMS: The aim of this study was to evaluate the efficacy and safety of a fractional RF handpiece such as this, on the Thai population. METHODS: Fifty-five Thai patients were treated with a fractional RF handpiece. The clinical assessment included a pain score, satisfaction survey, physician assessment, a combined patient and physician's assessment of skin condition, and clinical photographic assessments. The wound healing response was evaluated according to 5-time points: immediately after applying a pulse, post 24 hours, post 7 days, post 1 month and post 8 weeks. RESULTS: The obtained patient satisfaction score was "very satisfied" among 74% of the patients, post 3 sessions. Positive correlation was found between patient satisfaction and the physician's assessment. The skin condition assessment showed an increase from an average of 4.2 to 7.9. All treated symptoms improved after each treatment and the clinical outcome lasted at least up to 3-5 months. No significant adverse events were recorded. The in vivo prospective study showed a dose-related response in the deepness of the coagulation injury. In addition, there was evidence for a progressive healing process beginning shortly after exposure and completed within a week. CONCLUSIONS: This study clinically and histologically supports the efficacy of fractional RF handpiece in question with a high safety profile.